【摘要】：目的:研究經(jīng)前平顆粒對(duì)比氟西汀、安慰劑治療PMDD肝氣逆證的療效,探討肝主疏泄調(diào)暢情志的機(jī)理與PMDD病機(jī)特點(diǎn)的關(guān)系。使遣方用藥更具有針對(duì)性,證明中醫(yī)辨證論治思想治療PMDD肝氣逆證的優(yōu)勢(shì),為闡明從肝論治PMDD肝氣逆證,提供充分的實(shí)驗(yàn)和科學(xué)依據(jù)。方法:通過(guò)臨床流行病學(xué)調(diào)查,篩選55例符合PMDD肝氣逆證標(biāo)準(zhǔn)的受試者(18-45歲),進(jìn)行隨機(jī)雙盲雙模擬對(duì)照,給予經(jīng)前平顆粒、氟西汀和安慰劑治療三個(gè)月經(jīng)周期,根據(jù)“癥狀嚴(yán)重程度每日?qǐng)?bào)告”(DRSP)、“證候嚴(yán)重程度評(píng)價(jià)表”觀察癥狀變化,采用SPSS17.0對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析,對(duì)比三組藥物治療PMDD肝氣逆證的療效。結(jié)果:1.從DRSP結(jié)果分析:通過(guò)病的角度治療PMDD肝氣逆證,氟西汀對(duì)大多數(shù)癥狀都有明顯緩解作用(P0.01),經(jīng)前平對(duì)部分癥狀有緩解作用,安慰劑僅對(duì)個(gè)別癥狀有緩解作用,說(shuō)明通過(guò)辨病的角度治療PMDD肝氣逆證,氟西汀療效要優(yōu)于經(jīng)前平。2.從證候嚴(yán)重程度測(cè)評(píng)表結(jié)果分析:通過(guò)辨證論治的角度治療PMDD肝氣逆證,經(jīng)前平對(duì)PMDD肝氣逆證大部分癥狀及總體治療具有明顯療效(P0.01),氟西汀對(duì)部分精神癥狀有顯著療效,而安慰劑僅對(duì)頭脹有一定療效。表明通過(guò)辨證的角度治療PMDD肝氣逆證,經(jīng)前平療效要優(yōu)于氟西汀。結(jié)論:通過(guò)病的角度和辨證的角度治療PMDD肝氣逆證,經(jīng)前平和氟西汀療效不同。通過(guò)辨證論治,經(jīng)前平顆�？梢悦黠@改善PMDD肝氣逆證的癥狀,經(jīng)前平顆粒是根據(jù)PMDD證型肝氣逆證研制的中藥,體現(xiàn)了中醫(yī)辨證論治的思想,根據(jù)不同的證因證施治,療效更加顯著;證明了從肝論治PMDD的作用機(jī)制。氟西汀治療PMDD沒(méi)有分證型,降低了治療PMDD肝氣逆證的療效。但是從辨病的角度分析結(jié)果顯示,氟西汀效果較顯著。安慰劑對(duì)PMDD肝氣逆證某些癥狀也有一定療效。
[Abstract]:Objective: to study the therapeutic effect of Jingqian granule on PMDD with fluoxetine and placebo, and to explore the relationship between the mechanism of liver main dredging and regulating unobstructed emotion and the pathogenesis of PMDD. The purpose of this paper is to provide sufficient experimental and scientific basis for elucidating the treatment of liver qi inverses of PMDD from liver to liver by using Chinese medicine with more pertinence and proving the advantage of TCM dialectical treatment of liver-qi inverses. Methods: through clinical epidemiological investigation, 55 subjects (18-45 years old) who met the criteria of PMDD liver qi converse syndrome were selected and treated with Jingqian granule, fluoxetine and placebo for three menstrual cycles. According to "symptom severity daily report" (DRSP), "syndrome severity evaluation table" observe the symptom change ", use SPSS17.0 to carry on the statistical analysis to the data, compare the curative effect of three groups of drugs to treat the PMDD liver qi inverse syndrome. The result is 1: 1. According to the analysis of DRSP results, fluoxetine can relieve most of the symptoms of PMDD by treating liver qi inverses from the disease angle (P0.01). Jingqian Ping can relieve some symptoms, and placebo can relieve only individual symptoms. It shows that fluoxetine is more effective than Pian Ping. 2. 2 in treating PMDD liver qi inverses by the angle of disease differentiation. According to the results of syndrome severity evaluation table: treatment of PMDD liver qi inverses through syndrome differentiation and treatment, Jing Qianping has obvious curative effect on most symptoms and overall treatment of PMDD liver qi inverses (P0.01), fluoxetine has remarkable curative effect on some mental symptoms. Placebo only has a certain effect on head distension. The results showed that the treatment of PMDD liver qi inverses was superior to fluoxetine in the treatment of syndrome differentiation from the point of view of syndrome differentiation. Conclusion: the curative effect of premenstrual and fluoxetine is different in treating PMDD liver qi converse syndrome from the angle of disease and syndrome differentiation. According to syndrome differentiation and treatment, Jingqian Ping granule can obviously improve the symptoms of PMDD liver-qi inverse syndrome. Jing Qianping granule is a traditional Chinese medicine developed according to PMDD syndrome type liver qi inverse syndrome, which embodies the thought of TCM syndrome differentiation and treatment, and is treated according to different syndromes of syndromes and causes. The curative effect is more remarkable, which proves the mechanism of treating PMDD from liver. Fluoxetine treatment of PMDD has no syndrome type, reducing the treatment of PMDD liver qi syndrome efficacy. However, from the point of view of disease differentiation, fluoxetine is more effective. The placebo also has certain curative effect on some symptoms of PMDD liver qi inverses syndrome.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R271.115

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